Timing matters: Otological symptoms and Parkinson's disease

Abhimanyu Mahajan, Luca Marsili, Alok K. Dwivedi, Miguel Situ-Kcomt, Maria B. Grimberg, Nathan Wachter, Elhusseini Abdelghany, Kevin R. Duque, Alberto J. Espay

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Introduction: Otological symptoms contribute to the disability of established Parkinson's disease (PD). We sought to evaluate whether prodromal onset may affect PD progression. Methods: A retrospective cohort design was used to compare time to advanced disease, defined as a Hoehn & Yahr stage ≥3 in consecutive PD patients with history of auditory and/or vestibular symptoms appearing before versus after PD onset. Time from PD onset to H&Y ≥ 3 was determined using Cox proportional hazards, with adjusted results summarized as hazards ratio (HR). Results: After adjusting for age at PD onset, there was a lower risk of progression to advanced disease in patients with prodromal otological symptoms compared to those with otological symptoms after PD onset (HR = 0.34; 95%CI: 0.15–0.75, p = 0.008). This association remained significant after adjusting for age at PD onset and MDS-UPDRS III (HR = 0.25; 95% CI: 0.10–0.63, p = 0.003) and propensity score-adjusted analysis (HR = 0.46; 95% CI: 0.24–0.91, p = 0.025). Conclusion: Prodromal otological symptoms might be associated with a reduced risk of motor progression in PD.

Original languageEnglish (US)
Pages (from-to)23-26
Number of pages4
JournalParkinsonism and Related Disorders
StatePublished - Sep 2021


  • Hearing loss
  • Meniere's disease
  • Otology
  • Parkinson's disease
  • Vertigo

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology


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